LEFT-VENTRICULAR FILLING AND EJECTION FRACTION AFTER SUCCESSFUL PERCUTANEOUS BALLOON MITRAL VALVULOPLASTY

The effect of percutaneous balloon mitral valvuloplasty (PBMV) on left ventricular (LV) filling and ejection fraction (EF) still remains con troversial. We evaluated LV filling and EF in 23 patients (19 women an d four men, mean age 35.6+/-9.6, range 17-56 years) with mitral stenos is (MS) and sinus rhythm immediately before and after successful PBMV not complicated with significant mitral regurgitation and arrhythmia d uring left ventriculography. After PBMV mean mitral valve area increas ed from 1.4+/-0.2 to 2.2+/-0.3 cm(2) (P<0.01), mean mitral valve gradi ent (MVG) decreased from 18.6+/-5.7 to 6.9+/-3.2 mmHg (P<0.01) and mea n left atrial pressure (LAP) decreased from 26.0+/-8.2 to 12.3+/-5.2 m mHg (P<0.01). We did not determine any change in EF (before PBMV 61.8/-9.3% and after PBMV 61.8+/-7.6% (P>0.05)). Heart rate did not change significantly before and after valvuloplasty (P>0.05). Despite the de crease in LAP and MVG, the early diastolic filling fraction of left ve ntricle did not change (before PBMV 59.5+/-7.5%, after PBMV 57.8+/-8.9 % (P>0.05)). Also, we did not determine any increase in LV end diastol ic volume index (before PBMV 89.9+/-27.7 cm(3)/m(2) and after PBMV 84. 6+/-20.9 cm(3)/m(2) (P>0.05)). However, LV end diastolic pressure incr eased significantly after PBMV (from 6.6+/-3.0 to 11.3+/-4.9 mmHg (P<0 .01)). We conclude that in patients with MS, LV diastolic performance is impaired and LV EF does not change acutely after PBMV. (C) 1997 Els evier Science Ireland Ltd.